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Anejaculation is the inability to ejaculate semen despite stimulation of the penis via intercourse or masturbation. It’s actually a fairly common problem and can be frustrating for a couple trying to have children.

The symptoms presented by anejaculation are not to be confused by those of erectile dysfunction. During anejaculation, a man has a normal libido, gets aroused, has an erection, gets to the orgasm phase but there’s no sperm (which was the male reproductive cells and derived from the Greek word sperma meaning “seed”) that is ejected from the erect penis. After his orgasm, he loses the erection. Because of these conditions, anejaculation is usually self diagnosed but due to the symptoms, it might be confused for a sexual dysfunction or retrograde ejaculation. It’s important to know the differences.

During a retrograde ejaculation, the semen (also known as seminal fluid – it is an organic fluid that may contain sperm and other enzymes that allow the sperm to swim and fertilize an egg) goes backward into the urinary bladder, rather than coming forward. In this case, the post orgasm urine is cloudy. When sent to the lab for examination, the doctor will find sperm in the urine. This is why it’s important to figure out whether it was retrograde ejaculation or anejaculation?

What causes anejaculation? There are two types: anorgasmic anejaculation and orgasmic anejaculation. An anorgasmic anejaculation is when a man never reaches an orgasm either via intercourse or masturbation and therefore can’t ejaculate. There is no physical defect, instead his orgasm is limited by psychological factors like stress therefore, he might need additional stimulation during intercourse to reach an orgasm.

The other type is an orgasmic anejaculation. In this case, a man is fully erect, able to experience an orgasm, but not ejaculate. This could be due to blockage in his tubes or damage to the nerves. This could also be a combination of retrograde ejaculation, which is why it’s important to check the urine post intercourse and/or have an exam by a primary care doctor.

To receive treatment for symptoms of anejaculation, start by talking to your primary care doctor, however the catch is, they will ask for either a urine sample or a sperm sample. How does one give a sperm sample if you can’t ejaculate? In a relaxed environment, the doctor will create something called “coitus interruptus” – this basically the “pull out method” aka pulling out of a vagina before ejaculation and is often done at home so that a sperm sample can be collected in a beaker. If this is not possible, the doctor will attempt to vibrate the penis in an attempt to stimulate it to reach an orgasm and collect a sample for testing.  This type of stimulation results in 60% of ejaculations.  If vibrator therapy fails, the doctor will then perform electro-ejaculation. This involves the direct stimulation of the nerves in the seminal vesicles and is also a way to test if the nerves are damaged.  During this procedure, the doctor can also check for any blockage and if surgery is needed to clear the blockage in the urethra.

Anejaculation can also be physical. If you have had surgery due to an enlarged prostate, have Parkinson’s Disease, Multiple Sclerosis, or diabetes – these can also cause anejaculation. Therefore, it’s important to talk to your doctor and find out what exactly is causing your condition and if there are treatment options available.

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Author: drmaxmccullen

When Max McCullen first read Alfred Kinsey’s landmark book, Sexual Behavior In the Human Male, he began contemplating why so little is known about human sexuality. Since its publication in 1948 that body of knowledge has grown marginally. Why do we think about sex all the time? How much does sex really influence our behavior? And why do we still know so little about it? He completed undergraduate studies at University of the Pacific and The University of London and then his research led him to the Institute for the Advanced Study of Human Sexuality in San Francisco. IASHS was founded by Kinsey’s research assistant, Wardell Pomeroy. His initial curiosity soon evolved into a passion, which drove him to acquire his Doctorate of Education in Human Sexuality and Gender Studies. In 2004 Dr. Max began working for GlaxoSmithKline Pharmaceuticals (GSK), one of the largest pharmaceutical companies worldwide. This experience contributed to his understanding of medical treatments for male sexual dysfunction. He became familiar with how Viagra, Levitra, and Cialis function on a biological level and their social implications. His expertise naturally transitioned into him working with some of the most prestigious Urology offices in Southern California. These doctors and passionate medical personal, illustrated firsthand the impact treatment of male sexual dysfunction can have on patient care and their overall well being. This experience made him yearn for more direct contact with patients in a clinical setting. So after GSK he worked with Boston Medical Group (BMG), an international, clinic based organization, comprised of board certified Urologists and other specialties. BMG focuses on low libido, erectile dysfunction, premature ejaculation and testosterone replacement therapy. With BMG, Dr. Max was not only their spokesperson doing radio interviews and lecturing but worked as the physician liaison connecting patients with doctors for treatment. He also worked as a consultant for University Specialty Urologicals, based in San Diego, meeting with Urologists all over the west coast to train them on various treatments for men and women's sexual health issues, including hormone replacement therapy. During this time he also hosted online webinars for patients with questions; he also has a written and video blog series and does private consultation for patients. Dr. Max McCullen brings a historical knowledge of the human sexuality field together with the reailties of living in a digital age. “The issues that confronted our elders in the 50’s and 60’s are different today - but no more impactful. Where they were learning about their sexuality and beginning to embark into the sexual revolution we are over exposed to the commodification of sex. This makes the navigation of sex and emotional intimacy difficult” Dr. Max McCullen

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